If you’ve been trying to get pregnant for over a year (having regular, unprotected sex) then it’s highly advisable to book an appointment with your GP to rule out any fertility issues.
Your doctor will ask you a few questions, such as the length of time you’ve been trying to conceive for, how regularly you have sex, your medical history, general health and lifestyle, and how regular your periods are. This will help your GP determine whether you need to be referred to a specialist fertility team for further examinations.
Here are some of the most common initial fertility tests, which will usually be carried out in a hospital or fertility clinic.
Chlamydia is the most common sexually transmitted infection (STI) in the UK and can cause pelvic inflammatory disease and fertility problems. If you haven’t been tested for chlamydia recently and you’re trying to get pregnant then you’ll most likely need a urine test or vaginal swab.
An ultrasound will be carried out to check for any abnormalities on your ovaries, womb and fallopian tubes. A small ultrasound probe is placed in the vagina and this will help doctors check for things like endometriosis and fibroids, which can prevent pregnancy. The ultrasound scan will also look for blockages in your fallopian tubes, which may be stopping eggs from travelling along the tubes and into the womb.
One-third of fertility cases are due to the male partner, so your doctor will usually suggest a complete semen analysis, checking the number, shape and movement (motility) of the sperm.
A sample of your blood can be tested for a hormone called progesterone, to check whether you’re ovulating. If you have irregular periods, you will be offered a test to measure hormones called gonadotrophins, which stimulate the ovaries to produce eggs.
A hysterosalpingogram is a type of x-ray taken of your womb (uterus) and fallopian tubes after a special dye has been injected. This will outline the cavity of your womb and detect whether there’s a blockage of the fallopian tubes.
This test is usually only carried out if there’s a strong chance that you have fertility problems. It involves making a small cut in your lower abdomen so a thin, tubular telescope called a laparoscope can be used to look more closely at your womb, fallopian tubes and ovaries. Dye might be injected into your fallopian tubes through your cervix to highlight any blockages.
A hysteroscopy helps to identify and treat uterine conditions. Your doctor will insert a thin hysteroscope through the cervix into the uterus to see if there are any fibroids, scar tissue or other problems. A hysteroscopy can be done while you’re awake or under general anaesthesia.
Cervical mucus test and postcoital test
Sometimes problems with the cervical mucus can inhibit pregnancy. The cervical mucus test can help your doctor understand the quality and consistency of your cervical mucus which, in turn, can provide information on how your partner’s sperm interacts with your cervical mucus. A good time to evaluate your cervical mucus is right before ovulation takes place.
These fertility tests will uncover the cause of fertility problems in around 80% of cases. If, after you’ve undergone a fertility test, a clear cause has been found, your GP will talk you through the next steps. These will usually include referral to a specialist clinic for fertility treatment.